The role of perioperative nonsteroidal anti-inflammatory drugs use in cataract surgery.

PURPOSE OF REVIEW: Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used and studied by cataract surgeons for varied benefits in the perioperative period, but optimal medication formulae and dosing have yet to be established. In this article, we perform a literature review of articles published between 1 January 2016 and 30 June 2018 concerning perioperative NSAID use for patients undergoing cataract surgery. RECENT FINDINGS: Literature review revealed five areas of recent study including preoperative NSAID use for iatrogenic inflammation, intraoperative NSAID use for pupillary mydriasis, postoperative NSAID use for prevention of cystoid macular edema (CME), for prevention of pain/inflammation, and for improvement in patient quality of life. SUMMARY: Recent literature establishes the efficacy of a newly available intracameral phenylephrine-NSAID combination for pupillary mydriasis, postoperative NSAID use for preventing CME in certain high-risk populations, and postoperative NSAIDs for controlling pain and inflammation. However, further high-quality studies are required to determine the long-term effects of perioperative NSAIDs on visual acuity and CME rates.

Gender of Presenters at Ophthalmology Conferences Between 2015 and 2017.

PURPOSE: To analyze the proportion of women presenting at 9 major ophthalmology conferences over 3 years. DESIGN: Retrospective observational study. METHODS: Conference brochures from 9 national ophthalmology conferences from 2015 to 2017 were analyzed. Genders of first author presenters of papers and non-papers (moderators, presenters at symposia, panel discussions, workshops/instructional courses) were recorded. Comparisons were made to the gender ratio of board-certified ophthalmologists. Student t test and Cochran-Armitage trend test was used for analysis, with significance at P < .05. RESULTS: Of 14,214 speakers, 30.5% were female, statistically higher than the expected 25.4% (P < .001). Paper presenters were 33.1% female (P < .001) and non-paper presenters were 28.5% female (P < .001). When stratified to general or subspecialty conference, general conferences had a higher proportion of women compared to the American Board of Ophthalmology (ABO) expected rates (P < .001) for paper and non-paper presentations. The rates of female presenters increased over the 3 years only at the Association for Research in Vision and Ophthalmology (P = .009). Subgroup analysis showed that women presented 33.1% of papers but only 28.5% of non-paper presentations, which is lower than expected (P < .001). CONCLUSIONS: Our results highlight positive trends: the overall proportions of female speakers exceed ABO estimates of female ophthalmologists. However, the gender gap remains at many subspecialty conferences, especially for non-papers, which are more likely to require invitations rather than being self-submitted. As demographics continue to change, further efforts are needed to assure equitable selection of conference presenters.

Donor Diabetes Mellitus Severity and Corneal Transplant Suitability in a US Eye Bank Donor Population.

PURPOSE: To determine whether donor diabetes mellitus (DM) severity is associated with differences in endothelial cell density (ECD) and surgically unsuitable tissue. METHODS: Raw data were obtained from Saving Sight Eye Bank (Kansas City, MO) including 10,454 donated eyes from 5346 eligible donors from July 2014 through May 2017. Donors were grouped into 5 categories by their insulin use and the presence of microvascular end-organ complications. The categories were non-DM (NDM), noninsulin-dependent DM without complications (NIDDMnc), noninsulin-dependent DM with complication (NIDDMc), insulin-dependent DM without complications, and insulin-dependent DM with complication. Outcome variables included ECD and tissue transplant suitability. Mixed effects models were used to adjust for the random effect of repeated measures and fixed effects of donor age, race, lens status, and death to refrigeration and death to preservation times. Interaction effects of DM severity group and donor age and DM severity group and lens status were included in the models. RESULTS: One thousand six hundred eighty-four (32.1%) donors had a diagnosis of DM. Six hundred fifty-eight donors were in the NIDDMnc group, 225 in the NIDDMc group, 404 in the insulin-dependent DM without complication group, and 397 in the insulin-dependent DM with complication group. Compared with non-DM, donors with DM were older (P < 0.001) and more likely to be pseudophakic (P < 0.001). DM severity groups did not affect adjusted ECD at mean donor age. There was no statistically significant ECD interaction between DM severity group and lens status. There was a statistically significant ECD crossover interaction with NIDDMnc and donor age (P < 0.001). In phakic eyes, NIDDMc was associated with a statistically significantly lower odds of transplant suitability (odds ratio 0.62, P = 0.006). CONCLUSIONS: DM severity does not affect lowering adjusted ECD at mean donor age. DM severity and pseudophakia were not associated with lower adjusted ECD. NIDDMnc was associated with an attenuation of the age-dependent decrease in ECD. NIDDMc was associated with decreased transplant suitability in phakic eyes. Future studies should include age, lens status, and interaction effects in their models of ECD and transplant suitability.

Comparison of Pediatric and Adult Ophthalmology Consultations in an Urban Academic Medical Center.

PURPOSE: The purpose of this study was to compare pediatric and adult ophthalmology consultations in an urban academic center. METHODS: A retrospective chart review of patients evaluated by the ophthalmology consultation service from January through June 2014 was conducted. RESULTS: A total of 751 inpatients and emergency department patients were evaluated by the ophthalmology consultation service, of whom 152 (20.4%) were children and 598 (79.6%) were adults. The emergency department requested most of these consultations (42.8%), followed by internal medicine (39.1%) and pediatrics (18.4%) inpatients. More adult patients (94.5%) than children (76.5%) had abnormal findings on examination (P < .001). Altering management was recommended at a similar rate: 51.6% of pediatric patients and 54.3% of adult patients (P = .59). All children were initially seen by residents; children (38.6%) were more likely than adults (9.0%) to be seen with an attending physician (P < .001). Children (54.9%) were also more likely than adults (42.7%) to attend their recommended outpatient appointments (P = .027). CONCLUSIONS: The authors identified several interesting differences between the pediatric and adult consultation services. Although adult patients were more likely to have abnormal findings, the ophthalmology team recommended a change in management for more than half of each group. These rates of intervention suggest that it is equally important that children be considered for an ophthalmology consultation and examined as soon as possible. In addition, residents may need particular guidance in evaluating pediatric inpatients. [J Pediatr Ophthalmol Strabimus. 2017;54(1):17-21.].